Heiko Uthoff1, Daniel Holtz2, Pavel Broz3, Daniel Staub4, Luca Spinedi4. 1. Department of Angiology, University Hospital, Basel, Switzerland; Gefässpraxis am See - Lakeside Vascular Center, Clinic St. Anna, Lucerne, Switzerland. Electronic address: heiko.uthoff@hirslanden.ch. 2. Vascular Center Rapperswil, Rapperswil, Switzerland. 3. Department of Angiology, Limmattal Hospital, Zurich, Switzerland. 4. Department of Angiology, University Hospital, Basel, Switzerland.
Abstract
OBJECTIVE: Endovenous heat-induced thrombosis (EHIT) is a well-described complication of endovenous laser ablation (EVLA). We report our centers' experience on the efficacy (EHIT level ≥2 according to the Kabnick classification) and safety (observed major and minor bleeding events) of rivaroxaban for EHIT prophylaxis in EVLA with and without concomitant phlebectomy. METHODS: Demographic, procedural, and outcome data of all patients with EVLA of the great, accessory, or small saphenous vein and EHIT prophylaxis with 10 mg/d rivaroxaban between 2012 and 2014 were reviewed and analyzed in this investigator-initiated multicenter retrospective observational single-arm study. RESULTS: During a median (interquartile range) follow-up duration of 51 (41-68) days, complete vein occlusion was achieved in 98.4% of 438 EVLA procedures in 306 patients. One patient had an EHIT level 2 (0.2%; 95% confidence interval, 0.006%-1.3%). No major bleedings (0%; 95% confidence interval, 0.0%-0.8%) and six minor bleedings (1.4%; 95% confidence interval, 0.5%-3%) were observed. CONCLUSIONS: Rivaroxaban (10 mg/d) for 5 to 10 days seems to be an efficacious and safe alternative for EHIT prophylaxis in EVLA with or without phlebectomy.
OBJECTIVE: Endovenous heat-induced thrombosis (EHIT) is a well-described complication of endovenous laser ablation (EVLA). We report our centers' experience on the efficacy (EHIT level ≥2 according to the Kabnick classification) and safety (observed major and minor bleeding events) of rivaroxaban for EHIT prophylaxis in EVLA with and without concomitant phlebectomy. METHODS: Demographic, procedural, and outcome data of all patients with EVLA of the great, accessory, or small saphenous vein and EHIT prophylaxis with 10 mg/d rivaroxaban between 2012 and 2014 were reviewed and analyzed in this investigator-initiated multicenter retrospective observational single-arm study. RESULTS: During a median (interquartile range) follow-up duration of 51 (41-68) days, complete vein occlusion was achieved in 98.4% of 438 EVLA procedures in 306 patients. One patient had an EHIT level 2 (0.2%; 95% confidence interval, 0.006%-1.3%). No major bleedings (0%; 95% confidence interval, 0.0%-0.8%) and six minor bleedings (1.4%; 95% confidence interval, 0.5%-3%) were observed. CONCLUSIONS:Rivaroxaban (10 mg/d) for 5 to 10 days seems to be an efficacious and safe alternative for EHIT prophylaxis in EVLA with or without phlebectomy.